Pacific Blue Cross · Billing integration
Direct-bill Pacific Blue Cross, one service at a time, in real time.
Pacific Blue Cross is BC’s largest extended-health insurer. Clinicmaster submits each billable service synchronously and, when it is adjudicated, creates the funder invoice and the insurer payment immediately — with per-line reversal if something needs undoing.
The Pacific Blue Cross integration
Pacific Blue Cross is British Columbia’s largest private and extended-health insurer — a private payer, not the provincial plan. Clinicmaster submits claims to it in real time, one billable service at a time, and uses the adjudication response to create the funder invoice and post the insurer’s payment straight away. Individual lines can be reversed without unwinding the whole claim.
What the Pacific Blue Cross integration does.
Per-service, real-time submission means the answer is specific: you know exactly which service was covered, not just whether the visit was.
Real-time submission per service
Each billable item is submitted synchronously and adjudicated on its own, so coverage is resolved service by service rather than for the visit as a whole.
Invoice and payment created on adjudication
When a claim is accepted, Clinicmaster raises the funder invoice and posts the insurer payment immediately — the response is not something staff re-enter.
Patient pays the remainder, at the desk
Because the insurer’s portion is settled during the visit, the front desk collects only what is actually outstanding.
Reverse a single line
A claim line can be reversed on its own using its claim code and sequence, so correcting one service does not mean unwinding an entire visit.
Adjudication recorded against the invoice
The response is kept with the invoice it produced, which is what makes a query weeks later answerable from the record.
Credentials held server-side
Provider credentials and setup are configured per clinic and stored as secrets — there is no self-serve key entry in the app.
From service to settled line.
The service is recorded.
Each service delivered becomes a billable item on the visit, which is the unit Pacific Blue Cross claims are submitted as.
Each item is claimed in real time.
Clinicmaster submits the item synchronously under your clinic’s credentials and waits for the adjudication rather than batching it.
Invoice and payment are created.
An accepted claim immediately produces the funder invoice and the insurer payment; the balance stays with the patient to collect.
What this integration does not do
Coverage and adjudication are Pacific Blue Cross’s decisions — Clinicmaster submits and records them. This is a private insurer, separate from BC’s public plan: MSP billing runs through Teleplan and is covered on the BC MSP page. Provider enrolment with Pacific Blue Cross is arranged separately.
What Clinicmaster keeps per Pacific Blue Cross claim.
Real-time, per-service claiming produces a lot of small transactions. Each one keeps what it needs to be explained and reversed.
Back to regional billing- Billable item claimed
- Submission timestamp
- Adjudication outcome
- Amount paid by the insurer
- Patient responsibility
- Funder invoice created
- Insurer payment posted
- Claim code and sequence
- Reversals raised on the line
Pacific Blue Cross billing questions.
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